Towards multimodal brain monitoring in asphyxiated newborns with amplitude-integrated EEG and simultaneous somatosensory evoked potentials

Päivi Nevalainen¹, Marjo Metsäranta², Viviana Marchi³, Sanna Toiviainen-Salo⁴, Sampsa Vanhatalo⁵, Leena Lauronen⁶

Affiliations

¹ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland; BABA Center, Children's Hospital and Pediatric Research Center, University of Helsinki and HUH, Helsinki, Finland. Electronic address: paivi.nevalainen@hus.fi.
² Department of Pediatrics, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland.
³ Department of Developmental Neuroscience, Stella Maris Scientific Institute, IRCCS Stella Maris Foundation Pisa, Italy.
⁴ Department of Pediatric Radiology, Children's Hospital, HUS Medical Imaging Center, Radiology, University of Helsinki and HUH, Helsinki, Finland.
⁵ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland; BABA Center, Children's Hospital and Pediatric Research Center, University of Helsinki and HUH, Helsinki, Finland; Neuroscience Center, University of Helsinki, Helsinki, Finland.
⁶ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.

PMID: 33310460
DOI: 10.1016/j.earlhumdev.2020.105287

Towards multimodal brain monitoring in asphyxiated newborns with amplitude-integrated EEG and simultaneous somatosensory evoked potentials

Päivi Nevalainen et al. Early Hum Dev. 2021 Feb.

. 2021 Feb:153:105287.

doi: 10.1016/j.earlhumdev.2020.105287. Epub 2020 Dec 2.

Authors

Päivi Nevalainen¹, Marjo Metsäranta², Viviana Marchi³, Sanna Toiviainen-Salo⁴, Sampsa Vanhatalo⁵, Leena Lauronen⁶

Affiliations

¹ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland; BABA Center, Children's Hospital and Pediatric Research Center, University of Helsinki and HUH, Helsinki, Finland. Electronic address: paivi.nevalainen@hus.fi.
² Department of Pediatrics, Children's Hospital, University of Helsinki and HUH, Helsinki, Finland.
³ Department of Developmental Neuroscience, Stella Maris Scientific Institute, IRCCS Stella Maris Foundation Pisa, Italy.
⁴ Department of Pediatric Radiology, Children's Hospital, HUS Medical Imaging Center, Radiology, University of Helsinki and HUH, Helsinki, Finland.
⁵ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland; BABA Center, Children's Hospital and Pediatric Research Center, University of Helsinki and HUH, Helsinki, Finland; Neuroscience Center, University of Helsinki, Helsinki, Finland.
⁶ Department of Clinical Neurophysiology, Children's Hospital, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital (HUH), Helsinki, Finland.

PMID: 33310460
DOI: 10.1016/j.earlhumdev.2020.105287

Abstract

Background: Somatosensory evoked potentials (SEPs) offer an additional bedside tool for outcome prediction after perinatal asphyxia.

Aims: To assess the reliability of SEPs recorded with bifrontoparietal amplitude-integrated electroencephalography (aEEG) brain monitoring setup for outcome prediction in asphyxiated newborns undergoing therapeutic hypothermia.

Study design: Retrospective observational single-center study.

Subjects: 27 consecutive asphyxiated full- or near-term newborns (25 under hypothermia) that underwent median nerve aEEG-SEPs as part of their clinical evaluation at the neonatal intensive care unit of Helsinki University Hospital.

Outcome measures: aEEG-SEP classification (present, absent or unreliable) was compared to classification of SEPs recorded with a full EEG montage (EEG-SEP), and outcome determined from medical records at approximately 12-months-age. Unfavorable outcome included death, cerebral palsy, or severe epilepsy.

Results: The aEEG-SEP and EEG-SEP classifications were concordant in 21 of the 22 newborns with both recordings available. All five newborns with bilaterally absent aEEG-SEPs had absent EEG-SEPs and the four with outcome information available had an unfavorable outcome (one was lost to follow-up). Of the newborns with aEEG-SEPs present, all with follow-up exams available had bilaterally present EEG-SEPs and a favorable outcome (one was lost to follow-up). One newborn with unilaterally absent aEEG-SEP at 25 h of age had bilaterally present EEG-SEPs on the next day, and a favorable outcome.

Conclusions: aEEG-SEPs recorded during therapeutic hypothermia on the first postnatal days are reliable for assessing brain injury severity. Adding SEP into routine aEEG brain monitoring offers an additional tool for very early outcome prediction after birth asphyxia.

Keywords: Amplitude-integrated electroencephalography (aEEG); Asphyxia; Brain monitoring; Electroencephalography (EEG); Newborn; Somatosensory evoked potentials (SEPs).

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Towards multimodal brain monitoring in asphyxiated newborns with amplitude-integrated EEG and simultaneous somatosensory evoked potentials

Affiliations

Towards multimodal brain monitoring in asphyxiated newborns with amplitude-integrated EEG and simultaneous somatosensory evoked potentials

Authors

Affiliations

Abstract

Publication types

MeSH terms